# Region-Grounded Vision-Language Learning for Detection-Guided Mammographic Lesion Classification

arXiv: https://arxiv.org/abs/2607.15615 · HTML: https://mlsanity.com/paper/2607.15615/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical vision-language models, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 9 of its 14 references that are in the map.
- First posted on arXiv 17 Jul 2026.

## Placed in

- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 9 of 9)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [Mask R-CNN](https://mlsanity.com/paper/1703.06870/) (2017)
- [FCOS: Fully Convolutional One-Stage Object Detection](https://mlsanity.com/paper/1904.01355/) (2019)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [RegionCLIP: Region-based Language-Image Pretraining](https://mlsanity.com/paper/2112.09106/) (2021)
- [BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairs](https://mlsanity.com/paper/2303.00915/) (2023)
- [YOLOv12: Attention-Centric Real-Time Object Detectors](https://mlsanity.com/paper/2502.12524/) (2025)
- [DenseNet: Implementing Efficient ConvNet Descriptor Pyramids](https://mlsanity.com/paper/1404.1869/) (2014)
- [Mammo-CLIP: A Vision Language Foundation Model to Enhance Data Efficiency and Robustness in Mammography](https://mlsanity.com/paper/2405.12255/) (2024)

## Abstract (arXiv)

Vision-language models trained with contrastive objectives have shown promise in medical image analysis. However, conventional global image-text alignment is ill-suited for mammography, where diagnostically relevant lesions are spatially localized and occupy only a small fraction of the image. Subtle morphological cues critical for malignancy assessment can be diluted when representations are learned at the whole-image level. In this work, we propose a novel region-grounded vision-language learning method for detection-guided mammographic lesion classification. The method mirrors radiologists' diagnostic paradigm. First, a region-text contrastive pretraining stage aligns lesion-specific features with structured clinical descriptors derived from radiology metadata. To mitigate semantic collapse and background bias in low-vocabulary settings, we introduce a multi-component objective incorporating positive alignment, fine-grained semantic hard negatives, and background suppression. Second, an auxiliary lesion detection head is jointly optimized with contrastive classification to preserve spatial sensitivity and enable localization-aware malignancy classification. Extensive experiments on two independent datasets, CBIS-DDSM and VinDr-Mammo, show superior performance of our method compared to related methods under in-domain, cross-dataset, and transfer learning settings.